SUNY Downstate Medical Center (SUNY-DMC) proposes to renew its current AITRP by continuing to focus on the rapidly expanding injection drug use mediated HIV epidemic in Eastern Europe and Central Asia. The NYS International Training and Research Program (NYS-ITRP) was initiated as a Fogarty funded AIDS International Training and Research Program (AITRP) in 1993 to focus on Central Europe. It has since expanded to include 3 Baltic States: Armenia, Georgia, and Russia. This program represents a unique merging of an academic medical center, a school of public health and a state department of health, which combined with other training assets in New York State, allows us to respond to the continuing challenges of preventing new infections in the region. During the past 16 years, the combined AITRP has provided support for 76 long-term trainees, 3 of whom are still in training. They have been remarkably productive publishing over 650 articles and providing strong academic and public health leadership regionally and internationally. With this application we propose to expand our activities to Kazakhstan and Ukraine two countries with large IDU driven epidemics where we have identified strong local partners. We will continue to provide ongoing training to Russia, Georgia and Estonia and expand our training programs to include nurse training as well as enhance the development of regional public health training. The program's aims are: a. To build human resources capacity in our collaborating countries by providing long-term training in the US and ultimately in-country in population-based, biomedical and implementation research; b. To foster collaborative, interdisciplinary in-country research networks among our trainees and those supported by other programs; c. To utilize academic resources in New York State as well as the Fogarty network to ensure that the most productive assets are utilized for training efforts; d. To build in-country research capacity and productivity via a continuous mentoring process; e. To assist in the transition of in-country assets Into regional centers of excellence. In meeting its aims the NYS-ITRP's overall goal is to train a new generation of investigators capable of working in multidisciplinary environments capable of producing the research necessary to guide national priorities for successful treatment, prevention and care.